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Complementary and Integrative Therapies for Cardiovascular Disease
Complementary and Integrative Therapies for Cardiovascular Disease

Complementary and Integrative Therapies for Cardiovascular Disease by William H. Frishman, Michael I. Weintraub, and Marc S. Micozzi. St. Louis, MO: Mosby Elsevier; 2005. 456 pp. ISBN 0323030025. $51.95.

This is a fairly well-referenced book on the impact of various alternative and integrative therapies on cardiovascular disease. The book has 27 chapters, 9 of which were co-authored by Dr. Frishman and one of which was co-authored by Dr. Weintraub. The 27 chapters are divided into 6 parts. Part I covers The Placebo Effect in Cardiovascular Diseases and Legal Issues (Chapters 1 and 2), both well written and important chapters, especially for alternative/integrative health practitioners.

Part II covers nutritional and herbal therapies (Chapters 3 and 4), both subjects being well treated. Some of my own favorite herbs were discussed, including hawthorn leaf and flower extract (Crataegus spp., Rosaceae) for angina and congestive heart failure (CHF), garlic (Allium sativum, Alliaceae) for atherosclerosis and moderate cholesterol problems, Ligusticum wallichii (Apiaceae) for high blood pressure, tienchi or sanchi ginseng (Panax notoginseng, Araliaceae) for angina, ginkgo (Ginkgo biloba, Ginkgoaceae) standardized extract for cerebral and peripheral arterial disease, and horse chestnut seed extract (Aesculus hippocastanum, Hippocastanaceae) and butcher’s broom (Ruscus aculeatus, Liliaceae) for chronic venous disease, as well as many others.

On page 58 the authors state that “health claims can be made on the label” of nutritional products “if they are accompanied with a disclaimer saying that the product is not intended to diagnose, treat, cure or prevent any disease.” [Editor’s Note: Actually, the authors are mistaken: “Health claims” are risk reduction claims that are allowed for conventional foods and dietary supplements only after they are approved by the Food and Drug Administration as authorized by the Nutrition Labeling and Education Act of 1990 (NLEA). What the authors are obviously referring to are “statements of nutritional support” and so-called “structure/function” claims as authorized by the Dietary Supplement Health and Education Act of 1994 (DSHEA), which do not require FDA pre-approval but which marketers and manufacturers of “dietary supplements”—not “nutritional products”—must notify FDA within 30 days after such products are initially introduced into the market. Unfortunately, such misnomers and confusion are relatively commonplace when physicians and other conventionally trained health professionals attempt to write about regulatory issues about which they are often inadequately knowledgeable.] Unfortunately, some companies producing dietary supplement products have come under attack from the FDA, or even worse, the Federal Trade Commission, presumably because of governmental concerns about the way some manufacturers of dietary supplements are using structure/function claims of potentially dubious substantiality on dietary supplement product labels. The presumed rationale of the FDA and FTC is that such labels tend to confuse or deceive the naïve American public; unfortunately, current label restrictions make it more difficult for the general public to know which herb or dietary supplement might be reasonable to try for a particular health condition.

On page 72 under adverse reactions of L-arginine, it should have been noted that outbreaks of previously indolent oral or genital herpes can be caused by L-arginine unless simultaneously supplemented with a comparable amount of L-lysine.

Part III of the book (Chapters 5-8) covers different Mind-Body Approaches and overall is quite good, the weakest chapter being Chapter 6 on Hypnosis. Part IV of the book (Chapters 9-14) covers various “Alternative Medicine Practices” and most of these chapters are excellent. The chapter on Native American Healing is quite interesting but does not reference any scientific peer-reviewed literature to support its use; that is, if such literature exists. (This reviewer has not searched the peer-reviewed literature for the effects of Native American healing on cardiovascular diseases.)

Overall Part V on “Specific Approaches” (Chapters 15-26) is also quite good. Even though Chapter 20 on “Reflexology” is very practical and likely useful for health practitioners as well as the lay public, it is not well referenced from the peer-reviewed scientific literature; that is, if such literature exists. This reviewer has not searched the literature on this but has seen benefit from reflexology in his own patients with hypertension, heart disease, and many other chronic health conditions.

Chapter 25 on “Magnetic Biostimula-tion” lacks sufficient discussion about the difference between north pole magnetic therapy and south pole magnetic therapy, and the risks associated with their use.

Part V of the book would have been an appropriate section to include chapters on the effects of color therapy, focal infrared light therapy, pulsed magnetic therapies, micro-current and other electromagnetic therapies, dental therapies (root canals, ostitis cavitations and heavy metal toxicity), neural therapy, enhanced external counterpulsation therapy, and various detoxification therapies other than sauna. Part VI has just one chapter, “Integrative Medicine in Cardiothoracic Surgery,” which is well written.

Overall this book is very useful, especially for alternative/integrative health practitioners, all of whom should read the first two chapters very carefully. Hopefully this book will spur such practitioners into becoming involved in more clinical research projects in their practices so that the alternative therapeutic tools which they have seen working well anecdotally can be validated in the peer-reviewed literature and brought into mainstream medicine for the benefit of more people suffering from cardiovascular disease.

—William Lee Cowden, MD, FACC